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Caring for a Three Legged Dog or Cat

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10 year old mid-sized pup - osteosarcoma and amputation experience
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Perth, Western Australia
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14 January 2013 - 9:52 am
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I’ve been meaning to drop by for sometime and provide a bit of an update – particularly for any new people who may be facing treatment decisions with older, larger breed dogs.

 

Peda is (now) a 30kg sharpei / akita pup following her surgery at start of July 2012. I think 30kg equates to around 66lbs (according to google!). She was diagnosed with osteosarcoma in her left front leg at end of June 2012, with amputation conducted 11 July 2012. At the time of diagnosis, she was 9 years and 8 months old and was a very healthy and happy dog ‘for her age’! There was no real sign of arthritis at time of surgery which was awesome; and at the time of surgery, there was no other visible signs of spread (including having a clear chest CT scan).

She has had a number of health scares over the years, but has always weathered them well. 2011 saw surgery for suspected mast cell tumour on her right shoulder; she was given the all clear after that.

 

Surgery time

I do have to say that the first 2 weeks post-surgery were incredibly hard and I could not have gotten through that time without support of friends. A larger dog does mean you have to really consider your own physical capacity to look after them when they really cannot help themselves. While Peda was up and about fairly quickly, she had very limited ability to support herself as prior to surgery she had full use of both front legs. She had not begun to compensate in the front right leg and so she needed to build strength up in that leg. She face-planted an awful lot – somehow though it was usually pretty gracefully! She needed a lot of physical support for around the first 4 days which was physically incredibly exhausting for me (particularly when you factor in the emotional rollercoaster that surrounds diagnosis and decisions and surgery time). I had a wonderful friend come and sleep on the couch with me and she helped support Peda when I just couldn’t.

Pain meds were an unexpected difficulty to manage post-op. She was extremely distressed on one combination (fentanyl and tramal) and it took a few days to work out what was going on. Having said that, once we got the balance right, she was heaps better.

To be brutally honest, it was a horrific 2 weeks post surgery. Everything I was told at the hospital really did not prepare me for what was to come. Luckily I had read some very helpful posts on this site which did give me a bit of a heads up that it wasn’t necessarily going to be as easy as told.

I was so happy when she managed to go to the toilet on her own – it was like toilet training all over again – I was bursting with pride at what she achieved! Balancing on 3 legs is very tricky!

 

Chemo

Peda had four rounds of carboplatin every 3-4 weeks (number 2 was delayed a week due to low blood count and mild infection). Overall she was pretty good with chemo. It slowed her down a bit – but at 10 years old, she is pretty mellow anyway. I don’t think she would have coped with anymore than four treatments as the last one did knock her pretty flat. But she bounced back well.

 

The current status

I’m pleased to say that at the 6 month post diagnosis mark there was no obvious signs of spread (including having clear lung x-rays) … which is just awesome news.

Unfortunately the last month or so hasn’t been without some hurdles and she is starting to struggle quite a bit mobility-wise. Just before Christmas the vets did an arthroscope on her rear leg joints has she had taken a bad fall (chasing a naughty kitten on slippery floors (kitten didn’t play by the rules and run on the carpet)). It turns out she has moderate joint deterioration in one leg and mild deterioration in the other rear leg.

I was a bit gutted at this news knowing that it means we have to really reduce activity to try to look after her remaining 3 legs. She had no real sign of any arthritis prior to surgery (and was a significant reason I chose to go ahead with amputation).

However, I also have to keep it in perspective that she is a 10 year old larger breed dog and that inevitably meant some arthritis was going to kick in at some stage, irrespective of her tripawd-ness. She has started treatment with an course of injections which have seemed to help a bit. She is also on gabapentin again for pain relief and that seems to be a good drug for her.

It is also the middle of summer here in Perth and we have been having record temps (41-45C at Christmas (I think that is 105F – 113F) so really we are all struggling!

 

Would I make the same decision again?

If I wound the clock back to June last year and I was faced with the same decision, I would make exactly the same decision. At the time of decision I had made up a list of things that had to be ‘passed’ in order for amputation to go ahead. It was helpful in that I set a number of objective criteria that helped to guide the decision – I still ultimately had to decide, but I had no ‘excuse’ to back out. My biggest fear was whether it was the right decision by her … given her age and prognosis of the disease generally. If anyone wants to know the list, I’m happy to share (I think this post has gotten quite long at this stage so I’ll wrap it up!).

 

Peda’s strength and resilience through it all has shown me that it really was the right decision. It hasn’t been easy, but as I listen to her snore on her bed next to mine, I don’t regret it at all. I’ve had 6 months with my girl that I would not have had. Hopefully there are many more to come but I know this is a crap disease and our time is limited. I watch her play with her mates and chase the naughty kitten and she shows me that she is still able to be a dog – and a happy one at that. We sit out in the sun and she puts her head back and shuts her eyes and smells the breeze. I’ve no idea what she is thinking, but I know she is content and happy.

 

Having said everything above, I have to also add that every dog is different. From reading posts on and off over the last few months I have seen a massive variation in tripawd doggies journeys. I hope Peda’s story is able to give some insight to others struggling with very tough decisions.

 

Kirsty & Peda

The Rainbow Bridge



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14 January 2013 - 10:52 am
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clapclapclap

Bravo to you and Peda! I love this update, thank you. It’s honest and upfront, and you really don’t pull punches when you describe what the last year was like, and chemo too. I am so hoppy you decided to come back and take the time to share this journey with everyone here, because there are always new people who need to know what to expect. Yes, the first two weeks can be terribly rough, but things do get better if you stay strong and find support like you did. Yay for you!

I would love to see the list you made, and photos too! Please share when you can.

Take it easy out there. We have other Aussie Tripawds who are suffering through that awful heat right along with you, so you’re not alone. Keep cool and give your Tripawd Warrior Princess a big, big smooch from us!  May she go on for a long, long time.

Oh, what kinds of recommendations did the docs have to deal with her arthritis/joint disease?

It's better to hop on three legs than to limp on four.™
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14 January 2013 - 11:26 am
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This is definitely one of the most insightful updates I’ve seen in a while.  It covers a large time frame in a clear and concise manner. 

We live in a hot and humid environment, and for sure it takes a toll on them.  Trouble was always a bit droppy in the hot summertime.  Glad to hear it is going well for the two of you.  Hope to see many more positive updates in the future.

Shanna & Spirit Trouble ~ Trouble gained her wings 3/16/2011, a 27 1/2 month cancer survivor, tail wagging. RIP sweetheart, you are my heart and soul.  Run free at Rainbow Bridge.
The November Five - Spirits Max, Cherry, Tika, Trouble & Nova. 11/2008 - 3/2013 An era ends as Queen Nova crossed the Bridge.

New Haven, CT
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14 January 2013 - 7:07 pm
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I’ll echo what the 2 above mentioned: this is a very well written, very helpful piece on what it’s like to care for a larger, more senior tripawd.  I especially loved your last bit on looking back.  This perspective IS really helpful to folks and doggies like mine who are just starting this journey.  Jackson is a bit over 2 weeks from his amputation surgery and looking back on it, it was pretty rough, but it sure is made worse by all the emotions flooding our hearts and minds, huh?  Making the decision to amputate was easy for us, but it was its circumstance that is a harder pill to swallow.  Your words encompass the recovery almost perfectly: the physicality of it with a heaping dose of concern, confusion, frustration, anger, and love.

I love the visual of the 2 of you passed out (ok, she’s passed out snoring and you’re just loving the noise!) and enjoying life.  Way to go!!!  I hope you and Peda have a great week together and keep up a strong recovery for the next 6+ months.  Many thanks for this well written, beautiful, and helpful story.  Stay strong!!!

ACL tear in right hind leg 12/5/12 and scheduled ACL repair surgery 12/21/12. Pre-op xrays revealed osteosarcoma. Amputation 12/28/12.  Chemo (carboplatin) started Jan 10, 2013 and ended on April 5, for a total of 5 doses. He handled carbo like a champ!  No side effects.  We started metronomic therapy at his third chemo and have been also doing some holistic treatments.  He's a lively, playful 10 year old huskie-boarder collie and a very proud member of the Winter Warriors!  Our love. Our funny little guy!

San Diego, CA
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15 January 2013 - 5:05 pm
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Thanks for posting this. I’m sure it will be helpful to folks with older pups who find us here, wondering what to do.

It’s also always good to hear that folks have no regrets with their decisions.

I hope you have your girl with you for a loooong time!

Keep us posted,

Jackie, Angel Abby’s mom

Abby: Aug 1, 2009 – Jan 10, 2012. Our beautiful rescue pup lived LARGE with osteosarcoma for 15 months – half her way-too-short life. I think our "halflistic" approach (mixing traditional meds + supplements) helped her thrive. (PM me for details. I'm happy to help.) She had lung mets for over a year. They took her from us in the end, but they cannot take her spirit! She will live forever in our hearts. She loved the beach and giving kisses and going to In-N-Out for a Flying Dutchman. Tripawds blog, and a more detailed blog here. Please also check out my novel, What the Dog Ate. Now also in paperback! Purchase it at Amazon via Tripawds and help support Tripawds!

Perth, Western Australia
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16 January 2013 - 7:20 pm
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Thanks for all your kind comments on my post.

 

The List

The list was fairly simple, but when I set it I was adamant that if she didn’t meet the criteria then we wouldn’t go ahead with surgery and chemo. I had to approach it like that at the time for my own sanity. I was so scared about making the wrong decision for her. I’m not sure if I would have changed my decision if she hadn’t met one of the criteria … especially after reading stories here about other tripawds who, despite having visible spread at time of diagnosis, went on to have surgery / chemo (or other treatment) and still live a good happy period of time. Hindsight is a wonderful thing! All I can say is that I am glad that she got all the ticks on the list at the time as it made it ‘easier’ for me to decide to go ahead. In the weeks following surgery when I really questioned my decision, I remembered back to a good friend’s comments at the time that I should never doubt the decision I was to make – whatever that was.

 

In order to go ahead with surgery and chemo, the list that I drew up was:

  • no visible mets in lungs
  • no other obvious signs of spread
  • the ok from the orthopod team that she was a good candidate for amputation given her weight / age / joints
  • clear blood tests, including good kidney function, liver function
  • good physical health check results (e.g. no heart problems)
  • available funds

I added chemo to the decision as I felt (at the time) that if I was to put her through surgery, then I needed to give her the chance of as long as possible and so I had to weigh up how I felt about chemo. I know a lot of people don’t go ahead with chemo for many reasons. For me, it was a consideration – but I was unsure about it. Another friend who is a vet said that it is something you can ‘try’ – you don’t have to do the whole treatment protocol. That made it an easier decision as I didn’t feel like I was committing to something and so I could change the decision if it wasn’t in her best interests. The hospital were quite adamant that they don’t treat dogs with chemo if it is not in the dog’s interest – either because it is not working or the dog is too sick from treatment.

 

Peda has a history of kidney problems and digestive problems and is allergic to lots of things (particularly bees and wasps). So it was important to me that there was no other obvious health problems lurking that we might have to contend with. Of course, there is a limit to what you check for and they gave her a good physical workup and gave her a big thumbs up. They did a CT scan of lungs and they were clear – I figured that was even more reassuring than clear x-rays so felt very optimistic. Orthopod team declared her a very good candidate, and everyone was happy with her physical health – particularly given her age.

The costs of surgery and followup chemo were expensive. I have some lovely friends who covered the costs of the surgery (and have just said to pay them back later) so I’ve just had to cover costs of all following visits, chemo, meds and followup tests. That made it much more manageable and meant I could tick the funds item on the list.

On discussions later with her oncologist, I discovered they too have a list. Interestingly, they assess the owner’s geographic location (to the hospital), support and ability to cope – as well as the dog’s physical health and spread of cancer. We passed their list too!

 

Arthritis

Arthritis management has been to start her on a course of ‘pentosan’ injections – it is a widely used arthritis treatment in Australia. She also gets ‘sasha’s blend’ on her biscuits (it is a powder formulation of all sorts of things good for joints) and she also gets some sort of fish on top of her biscuits – sardines, tuna or salmon (she has z/d ultra prescription diet biscuits for breakfast and dinner). I’ve also trimmed the treats a bit and got her weight down by 0.5 kg – she wasn’t overweight before, but just dropping a little bit of weight was better. 

She is on gabapentin once a day to just help with pain management generally. That seems to be pretty good for her.

We’ve also been on fairly limited activity since she fell in November – which is partly to rest her joints and partly because the weather has been terrible. We are getting out for short walks – and long car drives! We go sit by the beach and go for short hops along the foreshore – she gets to be sociable and gets lots of pats. We also sit down lots and she sniffs the wind. Finding the balance of how far she can go is very tricky. I want her to build up stamina, but don’t want to stress the joints. Main thing is keeping her happy. She loooves car rides!

I was also cooking up chicken-rice (which is chicken, veges (spinach, broccoli, carrots, peas, sweet potato) – but I’ve been slack recently and I haven’t done that for awhile. That was not specifically for arthritis – just yummy food!

 

I’ll have a go at getting some photos up for you all to see big-grin

 

The Rainbow Bridge



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16 January 2013 - 11:00 pm
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I love love love the methodical way in which you approached this. It’s so hard to keep our wits about us when making decisions for our pets, but you did a terrific job! And how wonderful that you had so many great people in your life to turn to and help you make these important decisions. I especially liked how you said

Another friend who is a vet said that it is something you can ‘try’ – you don’t have to do the whole treatment protocol. That made it an easier decision as I didn’t feel like I was committing to something and so I could change the decision if it wasn’t in her best interests.

That’s what I think I forget to convey to people, is that you can always stop the treatments, you don’t have to commit to the whole thing. I’m glad you had someone say that to you. Taking things incrementally, step by step, is so much easier. Envisioning the next steps, not the entire journey, seems to make things less stressful.

Everything you are doing is so terrific. From her diet to helping her lose a little weight, to getting out and seeing the world. These things all add up to a great time, and keeping cancer away as long as possible. Nice!

 

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Crossing the rainbow bridge
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26 April 2013 - 10:09 pm
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Kirsty – thanks for sharing your and Peda’s story. It is surprisingly similar to our experience post-surgery. Our Tripawd Daisy also had a front leg amputation and we ended up getting her a front wheel cart from Eddie’s Wheels in Massachusetts. They ship all over the world and it has made a huge difference to her quality of life as we use it to go for long walks around the park. She is now almost 13, has been a Tripawd for 14 mos and had TPLO surgeries at 4 yrs and 8 yrs. Best wishes to you and Peda!

Perth, Western Australia
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17 May 2013 - 10:57 pm
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Hi Alicia

 

I did stumble across Eddie’s Wheels site when I had a bit of a look into a cart for Peda. I have to say, I was very impressed with their product. In the end I decided not to get one (for a variety of reasons) but have mentioned them to a few people since. They seemed to have a really good approach (especially with respect to the needs of front leg amputees). I did a lot of reading and research at the time and they were definitely the ones we would have gone with if I had proceeded down that path. 

Older doggies do definitely face different challenges to younger amputees – but I don’t regret having gone ahead with surgery. We passed her 10 month ampuversary last weekend. Given I didn’t think we would make her 9 month ampuversary as she was so sick at the start of April, I am just so grateful for every day we still have.

 

kirsty and peda

 

Virginia




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17 May 2013 - 11:34 pm
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Kristy and Peda……What a journey of love and hope you two are on:-) :-) COGRATULATIONS ON TEN MONTHS AND STILL GOING STRONG

Your Peda is a beautiful girl with a perfect balance of grace and gritty determination……just like her momma:-) :-) :-)

Always send I g you the best, Sally and Happy Hannah

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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18 May 2013 - 3:06 am
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yayyy peda pup woo hoo girl destiny is 3 months post amp and shes doing awesome leg twitches sometimes i need to upload pics and i would like to see pics of u and peda pup please im from australia destiny says g’day to everyone

Crossing the rainbow bridge
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24 May 2013 - 4:02 pm
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Kirsty – I know I’m a little late on this but happy 10 month Ampuversary to Peda! Thank you for your kind message – I hope your little Peda is doing well!

Sending good wishes and thoughts yours and Peda’s way.

Alicia and Angel Daisy

Perth, Western Australia
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26 May 2013 - 7:26 pm
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Hi Alicia

Thanks for your kind message – particularly during this sad time for you. I hope you are doing as well as can be expected and that you are being gentle with yourself during this time.

Peda is still with us and we are taking every day as it comes, knowing what is around the corner. But I don’t know when we will reach that corner and I’ve stopped worrying. There was too much ‘is it time’ contemplation and I was wasting valuable time and space to be with her. I’ve just asked her to make sure she lets me know when it’s time – and that she preferably does it in a non-traumatic way! (That’s my fear that I wait too long and miss the signs and we have a crisis).

K & P

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27 May 2013 - 7:55 am
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Kristy,

Your sharing of what you went through with Peda was helpful and insightful. We just have been diagnosed with our 9 year old male sharpei, mix that he has osteosarcoma in his right front. He is 80 lbs and has been in excellent health up to this news. We are scheduled for his amputation this Tues and home Thursday or Friday. We will begin chemo 2 weeks later.
It’s great to hear your girl has celebrated her 10th anniversary, congratulations.
Esther, Snoops Mom

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